Having 5 or More Pregnancies May Affect Heart Health

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CHICAGO — Having five or more children could increase women's
risk of developing heart disease, a new study in Hispanic and
Latina women finds.

Researchers studied 855 women of several Hispanic backgrounds
ages 45 years and older in Chicago, Miami, San Diego and New
York, and found that women who had five or more children were
three times more likely to have a heart problem that could result
in
heart failure compared with women who had never had children.

"During pregnancy, in order for a woman to support a fetus, her
cardiovascular system has to undergo immense adaptations," said
study researcher Dr. Shivani Aggarwal of Wake Forest School of
Medicine in Winston-Salem, North Carolina. These changes include
the thickening of the heart muscles — which can result in as much
as a 50 percent increase in the heart's mass — as well as
increases in cardiac output and heart rate. [ 8 Odd
Changes That Happen During Pregnancy ]

"All of this is thought to be reversible," Aggarwal said.
However, studies have suggested that, in women who have been
pregnant more times, the changes may persist after giving birth,
she said.

Previous studies also have found a link between having multiple
pregnancies and the risk of heart disease, but the issue hasn't
been studied in Hispanic women, even though this group has a high
rate of multiple pregnancies compared with other ethnicities, the
researchers said.

In the new study, the researchers found that the majority of
women had two or three children, and 12 percent of the women had
five or more.

Among the women with five or more children, 85 percent had a
heart function problem, called diastolic dysfunction, which is a
decline in the heart's performance in the relaxation phase of the
cardiac cycle.

Among the women with two to four children, about 60 percent had
diastolic dysfunction. Among women who didn't have children, 50
percent had diastolic dysfunction, which was unexpectedly high as
well, Aggarwal said.

The researchers also found that 27 percent of all women in the
study were using medication to control
high blood pressure.About 25 percent of the women had
diabetes, and 42 percent had pre-diabetes, meaning their blood
sugar levels were high but not high enough to be considered
diabetes.

Both high blood pressure and diabetes are risk factors for
developing diastolic dysfunction and heart failure, but when the
researchers adjusted the results for age, weight and health of
the participants, they found that women with five or more
children were still three times more likely to have diastolic
dysfunction than women with no children.

The findings suggest that the number of children a woman has may
be a "novel, underappreciated" risk factor for diastolic
dysfunction, and physicians should consider this when they treat
women with heart failure, Aggarwal said.

More research is needed to better understand
the changes to the heart and the body that occur during
pregnancy and their harmful consequences on the heart's function
leading to heart failure, Aggarwal said.

The study was presented Monday (Nov. 17) at the meeting of the
American Heart Association in Chicago.